Healthcare Provider Details

I. General information

NPI: 1912392770
Provider Name (Legal Business Name): JHENETTE RENEE LAUDER M.D., MSCI, FACOG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 HAMILTON BLVD STE 201
ALLENTOWN PA
18103-6122
US

IV. Provider business mailing address

19 BRADHURST AVE STE 2750S
HAWTHORNE NY
10532-2140
US

V. Phone/Fax

Practice location:
  • Phone: 484-664-7555
  • Fax:
Mailing address:
  • Phone: 914-493-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number11166853-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number315443
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number11166853-1205
License Number StateUT
# 4
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD483031
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: